 Dawn phenomenon: rise in blood sugar between 4 am and 8 am. not associated with hypoglycemia (associated with Diabetes Type 1 and 2)  Somogyi effect: combination of hypoglycemia during night with a rebound morning hyperglycemia that may lead to insulin resistance for 12 to 48 hours
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Hypothyroidism
 The result of decreased metabolism from low levels of thyroid hormones
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Pathophysiology
 Thyroid cells may fail to produce sufficient levels of thyroid hormones  The cells themselves are damaged and no longer function normally  Other times thyroid cells are functional but the person does not ingest enough substances needed to make thyroid hormones
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forming a goiter.
. the blood levels of TH are very low and the client decreased BMR The hypothalamus and Anterior Pit. TH is too low or absent. G make stimulatory hormones (TSH) as compensation TSH binds to thyroid cells and causes the Thyroid gland to enlarged.

 Cellular energy production is decreased & metabolites build up Myxedema. Decreased perfusion results in tissue and organ failure
. tongue thickened and edema to form in the larynx. course hair Myxedema Coma (decreased in metabolism in cardiac tissue causes the heart muscle to become flabby and chamber size to increase. making the voice more husky. Mxedema facefacedull puffy skin.

Etiology
 Most causes occur as a result of thyroid surgery and radioactive iodine treatment of hyperthyroidism  Common in areas where soil and water have little natural iodide (endemic goiter)
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Incidence/prevalence
 Women 30-60 years old 30 Women are affected 7-10x more often than 7men.
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